First 5 Initiative Greatly Boosted Oral Care For Kids
A new study by UCLA researchers has found that a program supporting oral care for young low-income children has dramatically increased the number of visits for preventative dental care.
The data from the Los Angeles-based dental homes project comes as more research indicates that oral care is tied into a patient's overall health and that such services are needed both early and later in life.
Currently, many low-income children between birth and the age of 5 receive scant dental care, oftentimes because parents assume that since infant teeth fall out they do not require rigorous care. According to federal data, only 36% of children between the ages of 2 and 17 enrolled in the Medicaid program received preventative dental care in 2011, despite being covered for such services. In California, the rate is far lower: Just 19%. Dentists – who tend to be more entrepreneurial and bottom-line oriented than physicians – are often reluctant to provide services to the Denti-Cal program due to low levels of reimbursement.
According to data from the Dental Health Foundation, more than half of California's children have tooth decay by the time they enter kindergarten. California ranks seventh-lowest in use of preventive dental services by children in the Medi-Cal and Denti-Cal programs.
Data suggest that poor oral health is connected to other healthcare issues such as heart disease, although the findings are far from conclusive.
“The majority of young children aren’t receiving crucial preventive and oral health services that they need,” said Nadereh Pourat, director of research at the UCLA Center and co-author of the study. “Avoiding cavities in primary teeth promotes healthy teeth for the rest of their lives.”
Researchers focused on the UCLA-First 5 LA 21st Century Dental Homes project, where care is provided outside of a dental practice. That initiative provides preventative oral care services to children at a dozen federal qualified health centers in the L.A. area. As part of the initiative, the clinics received funds to hire a community “dental home” coordinator, a part-time pediatric dentist and purchase dental equipment. The program, begun in 2012, is being funded from a $9.3 million contract by First 5 LA. UCLA is evaluating the results.
Although federally qualified clinics are mandated to provide oral care, such services remain a relative rarity in California: Currently, only about a third of community clinics statewide provide some form of oral care services. In addition to the provision of dental services, community service agencies were also provided resources to educate residents of the need for better oral health.
As a result of the initiative, preventative oral care visits rose 330% at the participating centers between between January 2014 and December 2015, or about 7,000 more in total. The number of visits for treatment and diagnostic services more than doubled during the same time period.
“Oral health is an essential part of a child’s development and this program is key to supporting health systems to better meet those needs,” said Kim Belshé, executive director of First 5 LA.
A greater focus is also being brought to oral health in older populations. CareMore, the Medicare Advantage health plan and delivery system based in Cerritos, has launched an integrated medical/dental care pilot program.
“We're thinking more broadly about how doctors, dentists and other providers can provide a broader range of services,” said Sachin H. Jain, M.D., CareMore's chief medical officer. Jain noted that providing dental services to CareMore enrollees is a strong hook to ensure more primary care visits as the senior population is more likely to visit a dentist multiple times a year than a physician. That's primarily because they want to preserve their teeth in order to continue eating solid food and maintain a high quality of life, Jain said.
